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NPI 1336061001

NPI 1336061001 : SRAVYA GUMMALURI BA, MA, LAC(NJ),NCC : FLEMINGTON, NJ

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General NPI Number Information
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    NPI Number           |    1336061001
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    Entity Type          |    Individual 
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    Provider Name        |    SRAVYA GUMMALURI BA, MA, LAC(NJ),NCC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/27/2026
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    Last Update Date     |    07/27/2026
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Provider Practice Location Address
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    Address Line         |    4 PROVIDENCE DR 
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    City                 |    FLEMINGTON
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    State                |    NJ
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    Zip                  |    08822-3447
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    Country              |    US
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    Telephone            |    908-512-7100
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    4 PROVIDENCE DR 
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    City                 |    FLEMINGTON
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    State                |    NJ
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    Zip                  |    08822-3447
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    Country              |    US
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    Telephone            |    908-512-7100
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101Y00000X
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    Taxonomy Name        |    Counselor
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    License Number       |    37AC00543800
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    License Number State |    NJ
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